Current surgical management in RET mutation carriers [Aktualne postępowanie chirurgiczne u nosicieli mutacji proto-onkogenu RET]

Endokrynol Pol. 2019;70(4):367-379. doi: 10.5603/EP.a2019.0021.

Abstract

Medullary thyroid carcinoma (MTC) still remains a rare endocrine tumor. 20-25% of MTC cases are genetically determined. The detection of the RET proto-oncogene mutation in 1993 allowed to understand the unique genotype-phenotype relationships in hereditary medullary thyroid carcinoma (HMTC) and formed the basis for therapeutic decisions based on the molecular results. Currently, prophylactic thyroidectomy is a commonly adopted and accepted therapeutic method. The decision on the time and extent of surgery should be made based on the results of molecular examination, the assessment of calcitonin (Ct) concentration and family history. Treatment of patients with HMTC requires the cooperation of a multidisciplinary team of experts and should be done in specialized centers only. The study is a review of the current guidelines for surgical management in the MEN2 syndrome.

Keywords: MEN2 syndrome; RET mutations; surgery.

Publication types

  • Review

MeSH terms

  • Calcitonin / blood
  • Carcinoma, Medullary / blood
  • Carcinoma, Medullary / congenital*
  • Carcinoma, Medullary / genetics
  • Carcinoma, Medullary / surgery
  • Disease Management
  • Humans
  • Multiple Endocrine Neoplasia Type 2a / blood
  • Multiple Endocrine Neoplasia Type 2a / genetics
  • Multiple Endocrine Neoplasia Type 2a / surgery*
  • Mutation*
  • Practice Guidelines as Topic
  • Proto-Oncogene Mas
  • Proto-Oncogene Proteins c-ret / genetics*
  • Thyroid Neoplasms / blood
  • Thyroid Neoplasms / genetics
  • Thyroid Neoplasms / surgery*
  • Thyroidectomy*

Substances

  • MAS1 protein, human
  • Proto-Oncogene Mas
  • Calcitonin
  • Proto-Oncogene Proteins c-ret
  • RET protein, human

Supplementary concepts

  • Familial medullary thyroid carcinoma